Study suggests nicotine pouches could aid tobacco harm reduction

Nicotine pouches may play a role in helping smokers move away from more harmful products, according to new US research published in JAMA Network Open.

The Rutgers Health study – believed to be the first to provide national estimates of daily pouch use – found that uptake among adults remains relatively low at 2.5 per cent, with the highest prevalence among former smokers and e-cigarette users who had recently quit. Researchers said this suggests pouches may be acting as a harm reduction tool for those seeking alternatives to combustible tobacco.

“Adults may be using nicotine pouches for harm reduction, given that use is highest among those who have recently quit another tobacco product or e-cigarettes,” said Professor Cristine Delnevo, director of the Rutgers Institute for Nicotine and Tobacco Studies.

However, long-term health effects remain unclear, and concerns persist about rising youth use. US survey data show pouch usage among middle and high school students increased from 1.1 per cent in 2022 to 1.8 per cent in 2024.

Earlier this year, a study published in Nicotine and Tobacco Research has revealed a steady increase in nicotine pouch use among adults and youth in Britain.

“We should always keep a watchful eye on youth tobacco-use behaviours, including use of multiple products, substitution with other products or alternative methods of finding and using flavored tobacco and nicotine products,” Delnevo said.

Yet, when used by established tobacco users, pouches may offer a health benefit, she added.

“People who have never used tobacco products should not suddenly be using nicotine pouches,” she said. “But for people who smoke or use other nicotine products and don’t want to stop using nicotine, switching completely from the more harmful product and moving down the risk continuum with nicotine pouches is a likely good for public health.”

Mary Hrywna, an associate professor in the Department of Health Behavior, Society and Policy at the Rutgers School of Public Health, and a study co-author, agreed.

“As nicotine pouches gain increased attention in the US, many agree that we need to better understand who is using these products and how,” Hrywna said. “This study offers a snapshot of use patterns that is informative and, at least for now, somewhat reassuring.”

In the UK, the findings arrive amid a fast-evolving regulatory environment. Disposable vapes were banned in June, and the Tobacco and Vapes Bill now progressing through Parliament is set to tighten rules on all nicotine products, including pouches. Measures will include a ban on advertising and sponsorship, restrictions on sales to under-18s, and powers for ministers to regulate flavours, packaging and displays.